PCOS and Keto

Curious if Keto is right for you to manage PCOS? Been told Keto is the way to control your insulin levels to prevent diabetes, improve ovulation to get pregnant, or get rid of your constant carb cravings?

Why is Keto so popular to treat PCOS?

Most people with PCOS experience high circulating insulin levels that promote intense carb cravings, absent or irregular periods, and problems with sleep. Finding a way to lower insulin potentially helps improve fertility, energy levels, mood, hair growth, and metabolism.

I didn’t mention weight and PCOS yet on purpose. I appreciate people promote Keto as a way to lose weight (aka weight suppress) and that assumes that weight CAUSES the high insulin levels and other PCOS symptoms. It doesn’t.

Weight gain or higher weight does NOT cause PCOS. It is a genetic condition passed down through families.

Assuming weight loss will help manage PCOS contributes to the constant weight discrimination found in the PCOS world.

I get it why Keto is so attractive to treat PCOS. But….

Keto doesn’t work for most people and long term research does not exist to support it for treating PCOS.

PCOS and Keto Research

With everyone recommending Keto for PCOS–doctors, dietitians, trainers, and Aunt Marge–you’d think there would be research behind it. Here’s the thing:

We have ZERO long term data on PCOS and Keto.

We do have 2 short term research studies though.

The most recent 2020 research describes:

  • studying 24 people with PCOS without hypothyroidism who weren’t taking Metformin or other insulin sensitizers.
  • 12 week duration–this is important!
  • used a Mediterranean style Keto with extra herbal supplements
  • Plenty of biomarkers improved like HDL, LDL, triglycerides, LH/FSH ratio, and testosterone. Weight decreased.
  • Small sample size and short duration were two of the many study limitations that make it not a generalizable recommendation. It also did not determine whether this diet was safe before and during pregnancy.

The other Keto and PCOS research–from 2005–describes:

  • Eleven people with PCOS were recruited for this study.
  • Study design was 24 weeks and people were instructed to limit their carbohydrate intake to a scary low amount and checked in every 2 weeks into an intensive education program.
  • Five people finished the study–this is important!
  • Plenty of biomarkers improved like LH/FSH ratio, fasting insulin and testosterone. Weight decreased.
  • There were non-significant decreases in insulin, glucose, testosterone, HgbA1c, triglyceride, and perceived body hair. 
  • Small sample size and lack of long term data (>2 years) were some of the study limitations.

Some follow up questions from this research:

  • I am curious what their fasting insulin, testosterone, blood sugar, blood pressure, FH/LSH ratio, ovulation, A1c, and weight was 2 years after completing the study. What are they today?
  • What is life like now with the study subjects? How is their relationship with food? Health is not just physical health yet includes mental and emotional health.
  • What was it like moving away from the rigorous research intervention to real life management of food? How did they experience grocery shopping, family get-togethers, and work dinners?

Six people were not able to continue with the Keto diet in that 2005 research article summarized above. What if that is the norm? How are they experiencing food now that they “failed” that diet? Why weren’t they further studied? (Writing this down for future PhD research.)

Are you ready to cut out a whole food group because 29 people were able to stay on a Keto diet for 3 to 6 months?

Are you ready to shame yourself for not sticking to a Keto diet because 29 people were able to stay on a Keto diet for 3 to 6 months?

Long term diet research–what it says about how it affects the body

We don’t have long term data to support ANY diet to treat PCOS. Yes, dieting is the go to first recommendation to treat PCOS yet even the 2018 PCOS Evidence Based Guidelines say we have ZERO diets that are shown to be sustainable and health promoting for people with PCOS.

Of note, we do have research that found people with PCOS who yo-yo diet more often experience binge eating. So there’s that.

Since we don’t have any long term PCOS diet intervention research to go on, we have to look at general population diet research. This is what it has found (all research looked at >2 years post diet intervention and findings were the same whether a person continued the diet or not):

  • Higher fasting insulin levels
  • Higher cortisol levels (an issue already with PCOS because of its associated chronic pro-inflammatory state)
  • Higher blood sugar
  • Higher incidence of diabetes
  • Higher blood pressure
  • More eating disorders among higher weight individuals
  • More binge eating
  • More weight cycling
  • More depression
  • Higher weight *please note I do not include this as a way to say higher weight is bad because I don’t think it is. I include it because I appreciate most people start a diet in hopes to weigh less. As such, long term dieting predicts weight gain rather than weight loss.

So now what? What can you do instead of Keto or other diets?

  • Move away from the scale as a measure of progress, health, and worth.
  • Be sure you are eating enough. Diets have fucked with your ability to know this. Be compassionate with yourself as you unlearn diet rules. Finding a person to help may make this easier.
  • People with PCOS probably need more protein. This doesn’t mean cut out carbs, sugar, or fat. Experiment with adding more protein at different times of day. Let your body tell you what helps and what doesn’t.
  • Consider your carb cravings as insight. They should be listened to, respected, and not shunned. Carb cravings are the way PCOS lets the person know that the condition needs attention. These cravings indicate that insulin levels are higher, or you are not eating enough, or need more sleep, or need to increase supplements, or medications, or need more protein.
  • Worrying about your weight will only keep you from trusting cravings. Worrying about weight won’t improve health long term and won’t make the cravings go away. Worrying about your weight will only make you more susceptible to binge eating experiences and intensify those cravings.
  • Find sustainable tools that help you lower insulin long term. These include eating enough, adding more protein, adding medications and/or supplements, resting more (and testing for a sleep disorder) and moving your body when you have the energy to do so.

Want more ways to help manage your PCOS without diets? Click here for a tool I designed just for you.

Looking for a non-diet PCOS community? Look no further than here.

(9) Sasha Ottey on turning challenges into advocacy

This Chapter of the PCOS and Food Peace Podcast is brought to you by Julie’s PCOS and Food Peace course. Get 25% off using the coupon code ‘podcast’ at check out. Get all the details here:

Did you enjoy the podcast? Leave us a rating, review, subscribe or share the podcast! Doing these small acts of kindness help the show grow and connect more with the concept of Food Peace.


Thank you to Theralogix, the makers of Ovasitol, for sponsoring the podcast.

  • Ovasitol is an inositol supplement with a blend of myo-inositol and D-chiro-inositol, in the body’s optimal ratio of 40 to 1.
  • Inositols are nutrients that help to decrease insulin resistance, promote menstrual regularity, restore ovulation, and balance hormone levels.
  • In convenient powder form, Ovasitol can be enjoyed in your favorite beverage or smoothie.
  • Available in both a canister and convenient single-serving packets, Ovasitol contains 100% pure inositols, with no additives.
  • Read our blog post about what Inositols can do to help your PCOS.
  • Order online today at theralogix.com. During checkout, use “PRC” code 127410 for an exclusive PCOS and Food Peace Podcast discount.
  • Enter to win a 90-day supply here! (We will be picking 4 random emails from those who enter during September 2018. All will be notified via email.)

I have PCOS and I know how overwhelming it can be.

This article was written by my previous Nutrition Grad Student, Kimmie Singh. She is a fat woman of color who experiences PCOS. You can find out more information about her work now as a dietitian here.


Hello everyone! I’m Kimberly Singh, a nutrition graduate student at The University of North Carolina at Greensboro.

Julie is my mentor, and with her assistance, I will be sharing PCOS information with you throughout the next three months. I’m a pretty typical student that enjoys reading, yoga, and gardening.

I have PCOS, so I know firsthand how overwhelming it can be. 

I understand what it feels like to question what PCOS is and what the best treatment options are. I have always been a very curious person, so I have found it difficult to blindly stick to a treatment plan without understanding how PCOS affects my body. This usually led to endless Google searches about PCOS. As you know, the Internet is a great place, but it never fails to provide mixed messages, especially about PCOS



Want to find a way to treat your PCOS without dieting? Grab a FREE download from Julie here.

Anyone that has visited WebMD knows how quickly medical Google searches can escalate. All of this makes it really difficult to understand what PCOS is and how it affects our bodies.

Now you may be wondering,

Wait, how do I know this series is any better than the other messages?!

Well, I will only be sharing evidence-based research with you all. So, I will take on the task of sifting through all of those mixed messages in order to share information that is supported by high quality research. As research continues, what we understand about PCOS will change and get more concise, so I will share up-to-date information.

Throughout the next three months I hope to help you understand more about your PCOS. I hope to share nutrition information that will nourish you, PCOS knowledge that will empower you, and support that will strengthen you.

I know firsthand how frustrating PCOS can be, but I also know that there is power in understanding our bodies.

I hope that this series will help you work with your PCOS toward Food Peace. More to come!

Want to explore more non diet options to help manage your PCOS, promote health AND healing?

Click here for details on Julie’s PCOS and Food Peace course.


Empowering Your PCOS Journey



Hello there!

I don’t have PCOS and there are some things (more like many things) I will never understand about the experience.

I really enjoy helping people affected by PCOS and I think it is time for we health care providers to give you more understanding and compassionate direction.

Are you sick of the standard PCOS advice:

“Just lose weight, eat less, and exercise more…that will fix it.”

Yeah, right.

*Cue the eye roll.*

Want to find a way to treat your PCOS without dieting?

Grab a FREE download from Julie here.

I’m sick of it too. I have spent the last 10 years sifting through research and seeking unique training to help your PCOS without the standard weight loss pitch. We know diets don’t work and focusing on the scale sets us up to fail. This goes for anyone including those affected by PCOS.

I have been teaching nutrition without diets to dietetic students since 2002 and was thrilled to meet dietitian-in-training Kimberly Singh. We clicked instantly. She let me know she is passionate about bringing sound evidenced-based nutrition information to the public and wants to be a non-diet dietitian.

And, she has PCOS.

Read about Kimberly’s experiences with PCOS as well as evidenced based info to help arm yourself with the most up-to-date research. This special series aims to help you understand PCOS, improve your relationship with food, and advocate for better care.

Click this image to jump to the topic that intrigues you….





























Want to explore more non diet options to help manage your PCOS, promote health AND healing?

Click here for details on Julie’s PCOS and Food Peace course.



I’m in a tug of war with food. {guest Evelyn Tribole}

062 Image

Have you tried embracing intuitive eating, only to feel as if giving yourself permission around food makes you lose control? Does making peace with food continually result in a tug-of-war with yourself? Do you struggle with healing your relationship with food, only to find yourself returning to diets when it feels too difficult? Listen now for some thoughts on how to move forward.

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Episode’s Key Points:

  • Body positivity doesn’t need to be associated with “letting yourself go” or being overfull! This overfull feeling has to do with DIETING, not body positivity.
  • Evelyn Tribole joins to help us tackle these intuitive eating struggles!!
  • Dealing with overeating when you first start exploring intuitive eating is a common struggle, and it can definitely be worked through! There’s lots of solutions here.
  • The diet industry makes us feel like we’re one bite away from poor health.
  • Remember that the process of intuitive eating and making peace with food is one of discovery and curiosity… there is no way to do it right or wrong!
  • We must connect with the body and become the expert of what own bodies need when we delve into intuitive eating. Clue into what you’re experiencing in your body, rather than in your mind.
  • You can’t make a mistake in intuitive eating! All bumps in the road are a part of the learning process. If you feel overfull, you haven’t done anything wrong! Just explore the experience and discover what is within it.
  • Trust the body, rather than pushing prescriptive rules and decisions. Our bodies have been silenced, and intuitive eating gives them a voice!
  • Interceptive awareness: the ability to perceive the feelings that arise in the body, both physical and emotional (all emotional feelings have a physical response!). Tapping into these feelings can help you get your needs met.
  • How do we move from shame or guilt to curiosity? Pause, and figure out what belief system we believe we’ve violated. Write down the thoughts and rules that we believe we are breaking.
  • Belief systems take a while to break down!
  • Treat your body as an experiment! Allow intuitive eating to guide you to become an expert of your body again.
  • Surround yourself with resources that promote self-kindness!!
  • Intuitive eating research is strong. There is a body of evidence that shows intuitive eating is health promoting!
  • Intuitive eating is getting more popular in the media… but most main news sites that cover intuitive eating focus on permission to eat, and forget about the rest of the 10 principles. We have to make sure that when people learn about intuitive eating, they learn about what it truly is in its totality!
  • When we take away the guilt and judgment around eating, we make room for satisfaction.
  • You are NOT alone!
  • The steps out of this tug-of-war will be challenging, but they will be worth it.

Show Notes:

Do you have a complicated relationship with food? I want to help! Send your Dear Food letter to LoveFoodPodcast@gmail.com. 

Click here to leave me a review in iTunes and subscribe. This type of kindness helps the show continue!

Thank you for listening to the Love, Food series. Give me feedback via Twitter @EatingPermitRD.


This episode is sponsored by my friends at Green Mountain at Fox Run.

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It’s time to shine the light on yourself and make YOURSELF the priority. Here at Green Mountain at Fox Run, we’re all about embracing and supporting yourself through self-care. Through powerful tools such as mindfulness techniques, stress management skills, and movement that is customized to your body and fitness level, you’ll learn to practice self-care in your daily life. Visit https://goo.gl/si9wZi for more information.

Green Mountain at Fox Run’s Binge Eating White Paper – Myths, Truths and Treatments

Download Green Mountain’s free whitepaper to understand Binge Eating Disorder, the most common eating disorder. Explore the symptoms of and treatment for BED, assess where weight loss fits in, and gain clarity on common myths. Visit https://goo.gl/UGpF78 for more information.